One of the most pressing concerns that people have when they’re involved in an automobile crash is their medical bills. The bills that they have incurred and that they are likely to incur in the future because of this car crash. “Who pays those bills?” is always a question on people’s mind when they contact us. The answer to that question can be somewhat complicated, but I will try to help you understand a little more clearly. It will also depend on various circumstances that you would need to know or discuss with someone, so we know specifically how this applies to you.
If your medical bills are incurred because of a traffic crash in the state of Florida, drivers in the state of Florida are required to have certain minimum insurance coverage. We refer to it here, in the state of Florida, as no fault insurance. I have another educational video on that if you’re interested in learning more about Florida’s no fault insurance law. One of the coverages that is required by Florida’s no fault insurance law is called personal injury protection, oftentimes referred to as PIP or P-I-P. The PIP coverage is a coverage that you are required to have as well as the other vehicle who might be involved in the crash. We assume when we’re discussing this that there is another vehicle, but under the PIP law there doesn’t have to even be another vehicle. It can be your fault. You could crash into a tree or you could crash into a sign and PIP, your personal injury protection insurance, is designed to pay your medical expenses. So, in an automobile crash setting, the personal injury protection insurance is considered the primary responsible insurance. Now, if you’ve already seen the no fault video, I apologize for repeating, but no-fault insurance, under PIP, pays 80 percent of reasonable and necessary medical expenses. Not 100 percent, 80 percent.
What about the other 20 percent? The other 20 percent can vary depending on your particular situation. Let’s talk about some of the options that are available for paying that other 20 percent or as is sometimes the case, if your medical bills are more than the amounts of your PIP coverage limits. Remember I said everyone is required to have PIP insurance but, the state of Florida only requires people have limits, the maximum that could be paid, of $10,000. If your bills exceed that amount then where does that money come from to pay those? Well, one place might be an optional automobile coverage that you can have on your automobile policy. You would want to look or go to an experienced professional and have them look at the details of your insurance policy. What you want to look for there is what’s called medical payments coverage or sometimes referred to as supplemental PIP, P-I-P. It is designed to supplement your PIP insurance, just like it sounds. Unlike PIP, however, which also pays lost wages, medical payments coverage only pays medical payments. So, the 20 percent that is not paid under PIP will be submitted to and should be paid by your own insurance carrier under your medical payments coverage, if you have it. As I said earlier, that is not a required coverage in the state of Florida, so you would have to check your particular insurance policy to determine if you have that coverage. Normally that coverage is sold in very small limits because it’s designed to supplement your PIP insurance. We oftentimes will see medical payment coverage limits of $2000 or $5000. When you stack that on top of your PIP limits of $10,000, it does not leave you a lot of insurance for payment of medical expenses related to significant car crash.
People always wonder, well, what about the other driver? What if they have insurance? Well, that is not set up in the automatic payment type situation like your PIP and your medical payments coverage. It’s also not even set up like your health insurance coverage. Let’s talk about health insurance, that’s another place and another layer where you would look for payment of medical expenses. There are different health insurers out there, and there are governmental health insurers. For example, Medicare and Medicaid, and then private health insurers like Blue Cross Blue Shield, Humana, and those type of places. Now all of those are based either on statute, if it’s a governmental entity, or if it’s a private insurance, you have a health insurance contract, that contract will outline and determine what benefits you’re entitled to and how much they’re willing to pay and able to pay for your medical treatment. That is an available route for you for the payment of medical expenses, even if those expenses are the result of a car crash. The thing to remember is that those insurers step in only after your automobile insurer under your PIP coverage.
Another thing that’s important to remember when you go to a medical facility or a doctor’s office is to give them all of your insurance information. Your automobile insurance information, your health insurance, your Medicare, your Medicaid, and your supplemental policy information. They all have highly trained billing specialists who know in what order to submit your medical bills so that they get paid properly and you’re not left holding the bag.
Lastly, you say wait a minute, this doesn’t seem fair, my insurance companies are paying for the medical expenses that were a cost to me because somebody else didn’t drive their car or truck properly. That makes sense, but that is coverage, if it exists, that you have to usually fight to get. The coverage that you would be looking for, from the at fault driver in a motor vehicle crash, is called bodily injury liability insurance. That does not pay automatically like health insurance or like PIP but can be a source to seek compensation to reimburse you for your past medical expenses that were not otherwise covered by your PIP. As well as a source to seek the protections necessary to ensure your health moving forward, your future medical care is caused by the negligence of another driver.
If none of those things exist, however, you may be stuck holding the bag yourself for your own medical expenses, and unfortunately, even if those were caused by the negligence of someone else.